Provider Demographics
NPI:1346377629
Name:MEININGER, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:MEININGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36880 WOODWARD AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-0919
Mailing Address - Country:US
Mailing Address - Phone:248-269-4100
Mailing Address - Fax:248-480-2399
Practice Address - Street 1:36880 WOODWARD AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0919
Practice Address - Country:US
Practice Address - Phone:248-269-4100
Practice Address - Fax:248-480-2399
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010527642086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM70420001Medicare PIN